Impact of Aging Population on the Health Workforce

This new publication by the Center for Health Workforce Studies assesses the effects of aging on the supply of and demand for different types of health professionals serving the U.S. population. Too few people are trained as geriatric specialists to meet the needs of older adults.  A 6% nursing shortage in 2005 will grow to a 29% shortage by 2020.  The authors suggest that access and ability to pay for care are major concerns among older adults, and there is a need for new skills and procedures within the health care delivery system. For more information, visit http://chws.albany.edu/index.php?aging.

New Resource Center for Direct Service Workforce

The U.S. government has created a new national Resource Center in response to the large and growing shortage of workers who provide direct care and personal assistance to disabled persons and older adults.  The direct service workforce includes support professionals, personal attendants, home health aides, Certified Nursing Assistants (CNAs), and others. The Resource Center offers a comprehensive searchable database of current research, best practices, and policy briefs related to the recruitment and retention of direct support professionals. Also included are program materials such as worker and supervisor training curricula, guidance on measuring workforce outcomes, recruitment materials, and peer mentorship program designs. To find out about other services, visit www.dswresourcecenter.org.

Money for Improving Care Unspent

The use of civil monetary penalties (CMP) and fines against nursing facilities is a largely untapped resource to improve quality of care, according to this new report. Facilities that violate standards of care are hit with federal and state penalties or fines. Collected CMP funds then form a pool of money that can be used in innovative ways to improve the quality of life for nursing home residents.  In 2005, 46 states reported having $60 million available in accounts from CMPs. To see the 29-page report Funding for Innovation: A Review of State Practices with Civil Monetary Penalties, go to www.ltccc.org.

Reasons for Nursing Home Placement

The Gerontologist (February 2006)

"The level of caregiver burden can predict nursing home placement."

This study of 2,200 caregivers of patients with dementia examines reasons behind continuing home care or placing a loved one in a nursing home. Of the caregivers who did place a family member in a nursing home, their reasons for placement included the need for more skilled care (65%); the caregivers’ health (49%); the patients’ dementia-related behaviors (46%); and the need for more assistance (23%). The findings suggest that the level of caregiver burden can predict future nursing home placement. The researchers recommend that caregivers be systematically screened for indicators of stress during routine doctors’ office visits.

Daily Drink Could Help Women's Cognitive Function

According to the Northern Manhattan Study, better cognitive function in women was associated with consuming one to two alcoholic drinks a day. These women 20% higher on the Mini Mental State Exam (MMSE) than women who didn’t drink at all or who consumed less than one drink a week. The difference remained the same after adjusting for risk factors such as income, marital status, race, ethnicity, and other vascular risk factors such as high blood pressure and cardiac disease. The 2,215-person sample was ethnically diverse (54% of the participants were Hispanic, 25% African-American, and 21% Caucasian), and the average age was 69.

Low-Cal Diet Cuts Aging

Journal of the American Medical Association (April 4, 2006)

"Following a strict low-calorie diet can decrease DNA damage linked with aging."

Longevity researchers say they’ve shown, for the first time, that following a strict low-calorie diet can decrease DNA damage linked with aging. The 48 participants in this study, all slightly overweight, were randomly assigned to one of four groups: calorie restriction; calorie restriction plus exercise; an 890-calorie liquid diet for up to about three months, followed by a weight-maintenance diet; and a control group who aimed to keep their weight steady. Average weight loss was about 18 pounds, with slightly more in the liquid-diet group. Blood tests showed substantial decreases in the amount of age-related DNA damage in each of the three dieting groups when compared with their initial levels. Government dietary guidelines for weight maintenance recommend 2,000 to 3,000 calories a day, depending on age, gender, and activity level.

Free Web Module on Diabetes Prevention

Diabetes Prevention and Management: Small Steps with Big Rewards is a free, web-based education program for professionals serving older adults. Created in collaboration with the Centers for Disease Control and Prevention and the National Diabetes Education Program, it offers information and tools to meet the challenges of preventing and managing diabetes in older adults. The module offers a nuts-and-bolts approach to developing successful programs. To learn more, visit www.asaging.org/cdc/module7/home.cfm.

Little Counseling About Exercise

Using data from the 2000 National Health Interview Survey, this study compares the prevalence of reported receipt of exercise counseling across four age groups of women to determine barriers to receipt of exercise counseling. A total of 6,385 women ages 50 and older responded to the survey, representing an estimated 34.5 million noninstitutionalized women nationally. Overall, 28% reported that a clinician had recommended that they begin or continue to perform any type of exercise or physical activity during the previous year. Women ages 75 and older were substantially less likely to report clinician exercise counseling.

Implementing a Home-Based Exercise Program

This study describes the results of the dissemination of a home-based exercise program called Strong for Life.  Implemented within a nationwide volunteer program called Faith in Action, Strong for Life included training for 103 volunteers who implemented the program and the recruitment of 105 older adult participants. The study looked at exercise adherence and attitudes and perceptions of program staff and participants.  Surveys were conducted with older adults, volunteer trainers, and Faith in Action sites at baseline and after the older adults had been engaged in the program for four months. Participants reported engaging in exercise on average 2.2 times per week, with 53% of the participants exercising at least two to four times a week. Participants also had significant improvements in a social functioning scale.

The Brain's Link to Walking

Neuropsychology (March 2006)

"Physical activity is associated with a lower risk of dementia in older men and women."Recent studies found that engaging in physical activity such as walking is associated with a lower risk of dementia in older men and women. Researchers gave cognition tests to 186 people ages 70 and older and then watched them as they walked through a corridor on a specially designed mat. The fastest walkers had higher scores on certain cognitive tests, including those that measure memory and planning abilities. Higher levels of verbal ability also were linked to faster walking in some cases.

Telephone-Based Support Groups Helpful

This study, conducted in Miami, Florida, demonstrates the value of conducting telephone-based support groups in reaching family caregivers. More than 40 caregivers participated in the Resources for Enhancing Alzheimer’s Caregiver Health (REACH) program, with support groups conducted over the phone in English and Spanish. Most of the participants (81%) reported the group as “valuable,” and the majority said that their participation had increased their knowledge and skills as caregivers. This type of support setting may be especially valuable to caregivers in hard-to-serve geographic areas. For more information, visit http://gerontologist.gerontologyjournals.org/cgi/content/abstract/46/1/134.

Trends and Practices in Family Caregiver Support

This 55-page report provides policymakers, program administrators, and advocates with an overview of emerging trends in caregiving; describes state approaches to developing practices and strategies; and identifies key factors fundamental to successful adoption of those strategies. This report highlights three trends in supporting family caregivers: assessment of caregivers’ own needs in order to tailor care plans and support services to meet those needs; consumer direction in support services that can be particularly effective in addressing the needs of families in rural areas; and collaborations between the aging network and health care providers.  To read the entire report, visit http://assets.aarp.org/rgcenter/il/2006_09_caregiver.pdf.

Social Well-Being and High Blood Pressure

Loneliness in people over the age of 50 greatly increases their risk of high blood pressure. In a study of 229 Chicago-area men and women ages 50 to 68, the loneliest people had blood pressure readings as much as 30 points higher than those who weren’t lonely.  The findings suggest that loneliness can be as bad for the heart as being overweight or inactive. Loneliness was strongly linked to high blood pressure even when risk factors such as weight, smoking, and alcohol consumption were also considered. With earlier research suggesting that more than 11 million Americans over 50 often lack companionship and feel isolated, the study could have major implications if reducing loneliness can lower blood pressure.

Lack of Sleep is a Risk Factor

Not getting enough sleep may be a significant cause of developing high blood pressure. Previous studies connected cardiovascular problems with sleep disorders, but it was not clear what effects they might have on hypertension. Researchers analyzed data from more than 4,810 people ages 32 to 86 who took part in the first National Health and Nutrition Examination Survey. Sleeping less than six hours per night more than doubled the risk of developing high blood pressure in persons 32 to 59 years of age.

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Power of Prayer Flunks Test

Researchers from the Study of the Therapeutic Effects of Intercessory Prayer (STEP) found that having people pray for heart bypass surgery patients had no effect on their recovery. In fact, patients who knew they were being prayed for had a slightly higher rate of complications. Researchers followed about 1,800 patients at six medical centers and tested the effect of having three Christian groups pray for particular patients. The patients were split into three groups: those who knew they were being prayed for; those who were prayed for but only knew it was a possibility; and those who weren’t prayed for but were told it was a possibility. Results showed no effect of prayer on complication-free recovery. Fifty-nine percent of the patients, however, who knew they were being prayed for developed a complication, versus 52% of those who were told it was just a possibility. See more information about STEP at http://journals.elsevierhealth.com/periodicals/ymhj/current.

Policy Implications of Ageism in America

International Longevity Center-USA (April 2006)

"Age discrimination is deeply embedded and widespread in American society." Discrimination in the workplace, elder abuse, lack of emergency preparedness for older adults, the negative impact of the media, and the marketplace on aging are the elements of ageism documented and analyzed in a new report. Ageism in America is 114-page document developed by a multidisciplinary task force led by Dr. Robert Butler. The task force found that age discrimination is deeply embedded and widespread in American society, and efforts to address the problem through policy responses and service provisions will be vital to achieving the highest quality of life for the aging population. The full report can be viewed at www.ilcusa.org/news/story_aging.htm.

Older Smokers More Likely to Quit for Good

Journal of the American Geriatrics Society (March 2006)

Duke University researchers tracked the health information of 573 older adult smokers from 1986 to 1996 and found that of those who quit smoking during the first three years of the study, the majority remained quitters until they died or until the end of the study period. Just 16% of the older quitters returned to smoking. This contrasts with previous research findings that young smokers who quit have a 35% to 45% rate of smoking relapse within two years of quitting. This low smoking relapse rate among older adults could be due, in part, to higher death rates in that group, but it also may reflect fundamental differences in habits and attitudes between older and younger smokers. Loss of transportation resulting in loss of access to cigarettes, the onset of dementia, financial constraints, or a relocation to assisted living or a relative’s home where smoking is forbidden are among the other factors that may influence quitting among older smokers.

Stigma Delays Alzheimer's Diagnosis

Alzheimer’s Foundation of America (March 2006)

Stigma about Alzheimer’s disease can delay its diagnosis for up to six years, according to results of a national survey of 539 American adults currently caring for a loved one with the disease. When people with Alzheimer’s were concerned about the stigma, a diagnosis occurred on average 3.5 years after symptoms appeared. The delay averaged six years when caregivers were similarly worried. The delay is serious because it ultimately impacts the management and treatment of the disease.  Learn more key survey findings at www.alzfdn.org.